Assignment: Cultural/Genetic Influence on Postpartum Hemorrhage Essay

Assignment: Cultural/Genetic Influence on Postpartum Hemorrhage Essay

Assignment Cultural Genetic Influence on Postpartum Hemorrhage Essay

 

Postpartum hemorrhage (PPH) can be defined as a blood loss of more than 500 mls after a vaginal delivery or more than 1000 mls after cesarean section or any amount that causes deterioration of the mother’s status (Sentilhes et al., 2016). PPH poses severe complications for the mother and is the leading cause of maternal mortality globally. Antepartum risk factors for PPH include Preeclampsia, nulliparity, multiple gestation, history of PPH, previous cesarean section, and high parity. Intrapartum risk factors include prolonged third stage, prolonged labor, episiotomy, assisted delivery, augmented labor, and fibroids (Sentilhes et al., 2016). The purpose of this paper is to discuss the cultural and genetic aspects that influence postpartum hemorrhage.

One cultural aspect that influences PPH is ethnicity, which is evidenced by the beliefs of some ethnic groups that postpartum bleeding is beneficial. They also have an attitude towards blood loss, which influences the perception of the danger of PPH. Some communities believe that bleeding after delivery is essential, healthy, and is a way of cleansing (Ononge, Okello & Mirembe, 2016). For instance, the Bariba community from Benin consider postpartum bleeding as normal and therapeutic and hence should not be prevented since it gets rid of impurities in the mother that may lead to pain or swelling. The Seri Indians in Mexico view postpartum bleeding as “bad blood,” and they make a broth to aid in its expulsion. Furthermore, some ethnic groups in Morocco believe that postpartum blood is harmful, and hence, a woman should have a certain blood loss to cleanse herself (Ononge, Okello & Mirembe, 2016). As a result, a high vaginal blood loss after delivery is overlooked, and factors to prevent PPH are not controlled.

Low socioeconomic status is recognized as a cause of maternal mortality due to PPH. This is because it limits women from making independent decisions affecting their health and access to healthcare (Wen et al., 2015). Besides, women with a low socioeconomic status may not afford healthcare services in facilities that offer advanced obstetric care that have resources and protocols to prevent PPH.

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Cultural beliefs about the etiology of postpartum bleeding significantly influence the health-seeking behavior in women when

they develop PPH. A majority of women seek healthcare depending on what they understand as the cause of bleeding (Finlayson, Downe, Vogel & Oladapo, 2019). For example, some communities in Nigeria women attribute antepartum and postpartum hemorrhage to evil or supernatural forces. As a result, they fail to identify early danger signs of hemorrhage and rely on traditional healers and traditional birth attendants for treatment. Other communities believe in the evil eye and result in them seeking cure from religious leaders rather than in midwives and doctors, which results in PPH.

Genetic Aspects That Influence PPH

According to a study by Oberg et al. (2014), approximately two-fifths of PPH following vaginal delivery is attributable to genetic factors, with the highest percentage being maternal factors. In the study, familial clustering was present in both of the main subtypes of PPH and was strongest in PPH caused by retained placenta (Oberg et al., 2014). Moreover, genetic disorders of coagulopathy, such as von Willebrand, may contribute to PPH due to a lack of coagulation factors needed to control bleeding. Women with polymorphism of the tissue factor gene are likely to have PPH since the gene is associated with PPH (Cooper & Brown, 2017).  Furthermore, there is a possibility that women with ACTA2 mutations might be at risk of uterine muscle dysfunction and PPH (Cooper & Brown, 2017). As a result, midwives and obstetricians should be alert for a woman with ACTA2 mutation and prepare early enough for the possibility of the woman developing PPH.

Postpartum hemorrhage (PPH) is responsible for around 25% of maternal mortality worldwide (WHO, 2017) reaching as high as 60% in some countries. In resource-poor settings, many uterotonics known to be effective in reducing PPH in tertiary care settings may not be useful in community settings because they require refrigeration and/or skilled administration (Subramaniyam, Chandran, & Priya, 2017) .
I will like to investigate the applicability and effectiveness of simple maneuver as midwives in decreasing the rate of PPH and the amount of postpartum blood loss in such settings.

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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

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Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

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Important information for writing discussion questions and participation

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Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource